Conditions
Dizziness is a broad word that means different things to different people. Vertigo is the specific feeling that you or the room is spinning, according to the NIDCD. Balance depends on three inputs: the inner ear, the eyes, and the position sensors in your neck and body. The brain pulls them together, so a problem in any one of them can cause dizziness or unsteadiness. This page covers common causes, what symptoms can look like, and how we look at balance problems at Strong Tower.
The NIDCD suggests talking with your doctor if you feel unsteady, the room seems to spin even briefly, you feel like you are moving when you are still, you have lost your balance or fallen, you feel lightheaded or about to faint, you have blurred vision, or you feel disoriented. If dizziness comes on suddenly or severely, or you think it could be an emergency, call 911 or go to an emergency department.
The NIDCD lists dizziness or vertigo, feeling unsteady or about to fall, staggering when walking, lightheadedness or a floating feeling, blurred vision, confusion or disorientation, and nausea or vomiting. Symptoms may be brief or long-lasting, and they can lead to fatigue.
Common causes listed by the NIDCD include medications, ear infections or other inner-ear problems, head injury or brain-related problems, and low blood pressure when you stand up quickly. Many balance problems begin suddenly with no obvious cause. Specific conditions we explain in more detail include:
BPPV, short bursts of spinning triggered by head movement
Persistent postural-perceptual dizziness (PPPD), chronic non-spinning dizziness that lingers after a vertigo event or concussion
Mal de Debarquement, a rocking or swaying feeling that lingers after a boat, flight, or long drive
Vestibular migraine, dizziness linked to migraine
The NIDCD says your doctor will first check whether another condition or a medication is responsible. For BPPV, a clinician may use the Epley maneuver, a series of head movements that moves particles in the inner ear. For people who cannot fully clear their dizziness, a vestibular rehabilitation therapist can build an individualized exercise plan.
At Strong Tower, we take a functional neurology approach to look at which part of the balance network may be struggling and build exercises to challenge it. Our evaluation is described on the Neurological Exam & Evaluation page, and our exercise-based care on the Vestibular Rehabilitation page. We see our care as complementary to your medical care.
Related conditions
Vestibular hypofunction means one inner-ear balance system is working below its normal level. Because the brain depends on equal input from both ears, the imbalance produces a constant sense of unsteadiness, visual blur with movement, and difficulty tolerating motion, even without dramatic spinning attacks. Causes can include a viral infection or inflammation of the inner ear, reduced blood flow to the inner ear or balance nerve, a head injury, and medications that are toxic to the inner ear. The brain can recalibrate through a process called central compensation, but compensation can stall when the visual and neck systems are also off, or when a person avoids movement. Vestibular rehabilitation is designed to support that recalibration.
A clinical practice guideline published in 2016 gives a strong recommendation to offer vestibular rehabilitation to adults with peripheral vestibular hypofunction (Hall et al., Journal of Neurologic Physical Therapy).
Visual and motion sensitivity is a pattern in which busy, moving, or patterned visual environments trigger dizziness, discomfort, or overwhelm, such as crowds, store aisles, scrolling, or being a passenger in a car. It is not a problem with the eyes themselves but with how the brain integrates visual input with the inner ear and body. It often appears after a concussion, a vestibular injury, or a period of high stress. Care may include exercises that gradually re-expose the brain to visual motion, along with work on the vestibular and neck inputs.
Cervicogenic dizziness is dizziness and unsteadiness that comes from the neck. It is usually a vague, non-spinning sense of being off balance that tracks with neck movement, stiffness, or pain. The upper neck holds the densest collection of position sensors in the body, and when those joints and muscles are stiff or injured, the brain can receive position information that conflicts with the inner ear and eyes. We look at the neck's contribution and may use joint, muscle, and balance exercises.
The Vestibular Disorders Association describes cervicogenic dizziness as a diagnosis of exclusion, meaning other causes such as medication effects, inner-ear conditions, and neurological conditions need to be ruled out first. It calls the diagnosis difficult (VeDA, updated 2020).
Tinnitus is the perception of a sound that has no outside source, often described as ringing. The NIDCD notes that causes are not always clear. They can include noise exposure, hearing loss, certain medications, earwax, head or neck injuries, and jaw joint problems. There is currently no cure, but treating a physical cause when one is found can reduce symptoms, and sound therapy and behavioral therapy can help people cope. The NIDCD recommends starting with your primary care doctor, who may refer you to an ear, nose, and throat doctor and an audiologist. It also says no vitamins, herbal extracts, or supplements have been proven to help (NIDCD, February 2023). If you have had that medical evaluation and are looking for further support, we can talk about how neck, jaw, and balance factors may play a role for you.
Dizziness is a broad term, from a brief feeling of faintness to a long-lasting spinning sensation. Vertigo is specifically the spinning sensation (NIDCD).
A spinning or moving feeling, unsteadiness or staggering, nausea or vomiting, blurred vision, and lightheadedness. Symptoms may be brief or long-lasting.
Inner-ear problems such as BPPV, infections or inflammation, head injury, medications, and low blood pressure on standing are among the causes the NIDCD lists. Sometimes there is no obvious cause.
It depends on the cause. The NIDCD says symptoms may be brief or long-lasting, so ask your doctor about yours.
Dr. Wright is a Doctor of Chiropractic with advanced training in functional neurology. Whether care here is a fit depends on the cause of your dizziness, which we look at in your evaluation. If your dizziness is new, sudden, or severe, see your medical doctor first.
If you are looking for care close to home, see our pages for:
Next steps
Your symptoms are part of the story, and we'd love to help you understand the rest.